Inflammation from rheumatoid arthritis can lead to lung disease, heart problems, nerve damage, and osteoporosis. Learn the warnings signs of these RA complications.

Although
rheumatoid arthritis (RA) is an autoimmune disease that affects the joints, the
chronic condition can also cause complications in other parts of your body,
including your eyes, lungs, heart, bones, nerves, and blood vessels.

"With
rheumatoid arthritis, many people think about inflammation affecting the
joints, but it can affect the entire body," says Dennis C. Ang, MD, section
chief of rheumatology and immunology and an associate professor at Wake Forest
Baptist Medical Center in Winston-Salem, N.C.

However,
early and aggressive treatment of RA symptoms can help reduce the severity of possible
complications associated with the disease, including:

Eye Complications

RA
also increases the risk for eye problems, such as dry eye syndrome. The whites
of the eyes and the cornea can become inflamed. Severe RA complications
involving the eye can result in blindness, Ang says.

Early
warning signs of these eye problems include:

Blurred
vision

Dry
eyes

Eye
pain

Difficulty
looking at bright lights

Red
eyes

Any
change or loss in vision

Lung Disease

About
10 to 20 percent of people with RA will develop chronic lung disease at some
point, Dr. Ang says. That's similar to the findings of a 2010 study published
in the journal Arthritis & Rheumatism that found the
lifetime risk of developing interstitial lung disease, a group of lung
disorders that inflame and scar the lungs, was 7.7 percent for people with RA,
compared with just 0.9 percent for those who don't have RA. The researchers
note the risk increased for those who had more severe cases of RA and those who
were diagnosed at a later age.

Not
only does the inflammation associated with RA increase the risk for lung
scarring, known as pulmonary fibrosis, but lung problems linked to RA may also
include blockage of the small airways and high blood pressure in the lungs. Additionally,
Ang says that some of the drugs used to treat RA can cause inflammation in the
lining of the lungs.

"Typically,
people show up in their doctor's office complaining of coughing or having
difficulty breathing during routine daily activities for a number of weeks,"
Ang says.

Heart Problems

Signs of
RA complications that affect the lungs, such as coughing and shortness of
breath, could also signal heart problems. This is generally attributed to atherosclerosis,
commonly known as hardening of the arteries, a common condition in people with
RA that seems to accelerate as the disease progresses. One review of studies, published
in the journal Rheumatology: Current Research in 2013,
reported that people with RA are 50 percent more likely to die from a
cardiovascular problem, two to three times more likely to have a heart attack,
and nearly twice as likely to have a stroke.

Ang
says that congestive heart failure is another complication that can develop
among people with RA. "Congestive heart failure isn’t a direct
complication," he says. "It's more of an indirect association after
many years of having rheumatoid arthritis."

Nerve Damage

For
people with RA, neck pain or balance issues could be a red flag for nerve
damage. RA can affect the upper portion of the spinal cord known as the cervical
spine. The deterioration of the joints in the neck can irritate and put
pressure on the nerves in the spine.

Initial
warning signs of nerve damage include:

Neck
pain

Problems
with balance, coordination, or walking

Strange
sensations or numbness in the hands and feet

Weakness
or loss of fine motor skills

RA
can also affect the peripheral nerves outside the brain and spinal cord. The
disease may compress the median nerve, which runs from the forearm through the
wrist to the hand. This can lead to carpal tunnel syndrome, which can cause
numbness or weakness in the hands and loss of hand function.

Inflammation of Blood Vessels

RA
can also lead to inflammation of the blood vessels, or vasculitis. When the
blood vessels become inflamed, they may narrow or shrink in size or get weak.
In extreme cases, this may stop blood flow.

Warning
signs of vasculitis include:

Painful
spots or redness on the nail beds, fingers, or hands

Painful
rash on the skin, often on the legs

Ulcers
or sores on the skin

Osteoporosis

The
inflammation associated with RA can also predispose people to osteoporosis, Ang
says. In addition, some medications used to treat RA can also lead to bone
loss. Additionally, being physically inactive or sedentary because of joint
pain can increase your risk for osteoporosis.

Warnings
signs of bone loss include:

Change
in posture or curvature of the spine

Broken
bones from a fall, particularly in the wrist or hip

Back
pain

"It's
important to make sure people with RA are getting enough calcium and vitamin
D," Ang says. "People with RA should have their bone density checked
every two years."

Low Blood Platelet Count

Blood
platelets are colorless blood cells important to blood clotting and stopping
blood loss. Low blood platelet count is usually caused by a separate disorder,
such as RA, or from a side effect of medication. "It's not really a direct
complication of rheumatoid arthritis, but some medications for this condition
can potentially cause low blood platelets," Ang says.

Symptoms
of a low blood platelet count include:

Easy
or excessive bruising

Bleeding
that looks like a rash of tiny reddish-purple spots on or just under the skin,
often on the legs

Prolonged
bleeding from minor cuts and scrapes

Blood
in urine or stools

Spontaneous
bleeding from the nose or gums

Unusually
heavy menstrual bleeding

Excessive
bleeding after dental work or during surgery

"When
treating rheumatoid arthritis, we check blood counts often so we can pick up a
low blood platelet count before it gets dangerously low," Ang says.

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